Building a Clinical Education Research NIHR Incubator.

Clinical Education Research (ClinEdR) can be defined as any research that contributes to the health and care needs of society by enhancing the education, training and development of health and social care practitioners and the structures and contexts in which they work and learn. ClinEdR encompasses research activity across all clinical professions including medicine, dentistry, nursing and all other health care practitioners. Its scope and potential for impact are far reaching, including evaluation of educational interventions and exploration of learners' experiences, through to the development of theoretical understanding of education in the field of health and social care. ClinEdR outcomes have potential for significant impact at a time when policy-makers are recognising the pivotal role of effective education and training processes in workforce sustainability.1 ClinEdR is however underrepresented in national research funding schemes and lacks attraction as an esteemed career destination due to a lack of opportunity or even lack of awareness of opportunity. As a result, many talented and enthusiastic researchers are unable to develop their careers in ClinEdR. In 2017, the National Institute for Health and Care Research (NIHR) established 'incubators' to build national research capacity in priority areas, such as ClinEdR. The funding associated with an incubator enables key stakeholders to work together to identify barriers and solutions to build research capacity in a meaningful way. Organised by discipline, incubators are virtual organisations across multiple sites tailored to the needs of each target area over a 3-year period. Incubators are awarded through a competitive process, with 'would-be' stakeholders required to set out the case for need for the discipline area along with their projected delivery strategy. In the case of the ClinEdR incubator, the application for the second tranche of incubators was led by three colleagues based within the Faculty of Medical Sciences at Newcastle University. Each of the co-leads were motivated by their own experiences and those of others to apply. The incubator for ClinEdR was one of eight awarded in April 2020 with its stated vision 'To lead a strategic expansion of career researchers in clinical education, driving processes and culture change in order to position educational research as an esteemed career destination.' In aiming to deliver this vision, the ClinEdR incubator sought to improve the visibility of ClinEdR as a career destination for academic researchers from all clinical professions and address systemic barriers that affect entry and progression in the field. Following the award, the co-leads set about developing the necessary networks and governance processes. They held a series of online meetings to brain storm potential collaborators, stakeholders and incubator members. Many of these were identified through personal networks and affiliation to stakeholder groups such as other Higher Education Institutions (HEIs) and regulatory bodies. Further recruitment to the network was undertaken by 'snowballing'. A project manager was appointed to support the incubator, and the governance structures formalised. This included the establishment of a small executive group to lead decision-making to enable the incubator to achieve its strategic objectives, and be responsible for monitoring and achieving progress, including developing a brand for the incubator. A larger advisory network was formed and was inclusive of anyone with a legitimate interest in the work of the incubator. With over 90 members, this ensured a 'joined up' strategic approach, with inclusion across all professions, and defined and reviewed workstreams drawn from its membership as well as facilitating partnerships with other organisations in ClinEdR and other relevant disciplines such as public health. In establishing the advisory network, there was a purposeful targeting of academics from all career stages and from all professions. Likewise, whilst the NIHR's primary focus is on England, the incubator reached out to the devolved nations in its bid to be as inclusive as possible. To that end, PPI and EDI have been at the heart of the incubator strategy. The incubator was formally established in August 2020 with development of a website and a social media presence. To develop this network, we took a number of steps, which may provide a useful framework for others embarking on a similar endeavour. An online launch event took place in Feb 2021 attracting over 100 invited delegates representing relevant organisations such as HEIs, professional bodies, societies and funders. Four initial workstreams were established to define ClinEdR and its scope, deliver the communication strategy, explore interprofessional differences and develop support and development activities. Since its foundation, the incubator has achieved many successes including delivery of multiple on-line and in person workshops and lectures aimed at supporting novice researchers and those who may be supervising them. It has undertaken active research to explore barriers and enablers to involvement in ClinEdR for undergraduates and career challenges of novice researchers. It has engaged extensively with other stakeholders to prioritise impactful areas and influenced funders to create Education focussed calls. Through sub-groups, the incubator now has a voice on academic career pathways in dentistry. It has successfully supported, and continues to support, colleagues make applications for fellowship grant funding. Recognising that there was unfinished business, in 2023, the incubator leads successfully bid for a renewal of the incubator for a further 3 years. This was duly awarded with the intention to focus on a set of particular areas: supporting entry to ClinEdR careers for novice and early career researchers (ECRs); improving equal access for those in nursing, midwifery, allied health professions and other under-represented groups; and supporting ECR development towards doctoral research. Finally, we have a dedicated goal of ensuring sustainability through faculty development to expand a network of supervisors and collaborators and creating a successor body to provide an effective ongoing legacy after the renewal period. The five articles recently published in The Clinical Teacher that make up this series are as direct result of the work of the incubator and its network. These 'how to' papers address a number of topics identified by incubator community as representing areas of challenge in developing ClinEdR projects and careers in the field. The resultant papers are intended to provide some of the tools needed to support a growth in capacity in this important research field. All the papers were authored by collaborations between established and more junior ClinEdR researchers, reflecting the incubator's ethos of listening to, and supporting, those seeking to develop in the field. The first paper considers how the 'pipeline' into ClinEdR can be more effectively filled by involving and inspiring undergraduate students. It does so by reflecting on the experience of those education providers who have been particularly successful at doing this previously. The second paper aims to debunk some of the myths associating with starting a career in ClinEdR. Aimed at novice researchers, this paper draws on the literature and personal experiences of the authors to provide advice for those entering into this area. The third paper is aimed at a wider community of educational faculty and describes how to support others to develop a career in clinical education research. It will also be of interest to researchers currently working in the field. The penultimate paper considers how to 'grow a team in ClinEdR' using a structured and carefully considered approach. Highly pragmatic, the paper aims to support the development of well-functioning, impactful and mutually beneficial teams. Finally, the authors of the fifth paper consider the crucial issue of how to successfully find and apply for funding for ClinEdR. They give a host of practical tips around applying for funding. In writing this editorial and the five subsequent papers, we hope that we have provided insight into not only our own experiences of establishing the incubator community but also some potential strategies to overcome barriers to grow a successful career. We hope that you will find these papers interesting and useful. The authors have no conflict of interest to declare. All authors contributed to the data analysis and manuscript preparation. All authors agreed the final manuscript. The authors would like to acknowledge members of the executive group who have significantly contributed to the early successes of the ClinEdR NIHR incubator: Prof Karen Mattick, Professor of Medical Education, University of Exeter; Dr Peter Yeates, Lecturer in Medical Education Research, Keele University; Dr Richard Conn, Academic Clinical Lecturer, Queens University, Belfast; Prof Gabrielle Finn, Professor of Medical Education, University of Manchester; Dr Aileen Barrett, Editor in Chief, The Clinical Teacher and assistant Scheme Director GP Training (South East) Waterford, Ireland; Dr Megan Brown, Senior Research Associate, School of Medicine, Newcastle University; Prof Gary Frost, Chair in Nutrition and Diet, Imperial College, London; Dr Simon Fleming, Orthopaedic Surgeon, Royal North Shore Hospital, New South Wales, Australia; Jayne Parry, Professor of Policy and Public Health, Institute of Applied Health Research, Birmingham University; Charlotte Minter, Senior Programme Manager, NIHR. The authors have no ethical statement to declare.